Individual provider Active NPI

Olugbenga Adeola Ogunleye

  • Registered Nurse
  • West Haverstraw, NY
National Provider Identifier
1114150356
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
666647 Issued in NY
Practice address
5 Patterson Dr
West Haverstraw, NY 10993-1113
Phone
(845) 942-8451
NPI assigned
Sep 3, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 297873 NY
Registered Nurse 163W00000X 666647 NY Primary

Addresses

Primary practice location

5 Patterson Dr
West Haverstraw, NY 10993-1113

Mailing address

5 Patterson Dr
West Haverstraw, NY 10993-1113
Phone (845) 942-8451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
666647NYMDRegistered Nurse
297873NYMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1114150356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PATTERSON DR",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931113",
            "telephone_number": "845-942-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PATTERSON DR",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931113",
            "telephone_number": "845-942-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUNLEYE",
        "first_name": "OLUGBENGA",
        "middle_name": "ADEOLA",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-03",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "297873",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "666647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haverstraw, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.